Posts for: March, 2019
In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?
“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.
How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.
With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.
In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.
While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.
Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”
We often associate orthodontics with moving several teeth on the upper or lower arches (or both) with braces or clear aligners. But not all patients require a major endeavor — sometimes only one or a few teeth need to be moved, and not very far.
A slight gap between the two upper front teeth is one type of situation that only requires minor tooth movement: just a few teeth need to be moved and usually just a millimeter or two. The appliances needed to achieve this are also relatively simple in design: removable retainers or small scale fixed braces with small springs or elastics that place pressure against the teeth. The process may also only take a few months rather than two years as with major tooth movement.
Preparing for the procedure, though, must be undertaken with great care. We need to first determine if moving the teeth even slightly could affect the bite with the opposite teeth. We must also ensure the roots of the teeth intended for movement are in good position for allowing the space to be closed.
We must then consider the other supporting structures for the teeth. It’s important for gums and bone to be healthy — if not, treating any found disease may be necessary first before beginning orthodontics. And, if the gap between the two upper teeth was created by an abnormally large frenum, the small strip of tissue connecting the lip to the upper gum, it may be necessary to remove it before tooth movement can begin to ensure the closed gap stays closed.
Like any other orthodontic treatment, minor tooth movement first requires a thorough examination with x-ray imaging to determine the exact tooth position, bite issues and the surrounding gum and bone health. We can then be reasonably certain if this straightforward procedure is right for you, and could help you obtain a more attractive smile.
If you would like more information on different orthodontic treatment choices, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Minor Tooth Movement.”